RECOVER: Subsequent Infections, Manuscript Tables and Figures

Author

Nhat Nguyen PEDSnet Coordinating Center

Published

October 11, 2024

Report for progress on study modeling and analysis for the comparison of the presence of post-acute RSV infection in COVID-positive patients compared to comparison groups (influenza and other acute respiratory infections).

1 Main analysis: Any respiratory infection analysis (original aim 2&3)

  • This version of the report excludes the following sites whose proportion of influenza lab-confirmed cases is < 20% from Nov-1, 2022 to Apr 30, 2023:
    • Monte, Nationwide (borderline)
    • Columbia, Emory, Intermountain, Ochsner, Temple, UTH, OSU, UTSW, Wakeforest

1.1 Supplemental Table 5a : attitrion talble for a) main cohort evaluating the outcome of any respiratory infection

This attrition table considers the cohort entry period to be defined from June 1, 2021 to March 1, 2023. This means that the study outcome window will extend from July 1, 2021 to March 1, 2023.

Attrition based on cohort inclusion criteria. Inclusion criteria were computed according to the following rules.

  • Patients under 6 years old with at least one visit during cohort entry period (June 1, 2021 to February 01, 2023 may be tightened as desired)

  • Had evidence of either SARS-CoV-2 infection or Influenza infection within the cohort entry period

  • Had at least 1 visit within 18 months of index date, and at least 1 visit in the 1-6 months following the index date (follow up period)

  • Exclusions:

    • No prior SARS-CoV-2 ever, via test, diagnosis, or serology positive

    • No Influenza within pre-acute or acute period (6 months before index)

    • No prior RSV (outcome) or RSV within acute period

    • No co-infection of Influenza and SARS-Cov-2 within acute period

    • For influenza index infections, no other respiratory infection positive tests within 14 days of index date. Other respsiratory infections include:

      • Adenovirus
      • Coronavirus 229E, HKU1, NL63, OC43
      • Human Metapneumovirus
      • Human Rhinovirus/Enterovirus
      • Influenza A virus A/H1, A/H3, A/H1-2009
      • Influenza B virus
      • Parainfluenza virus 1, 2, 3, 4
      • Respiratory syncytial virus
      • Bordetella parapertussis
      • Bordetella pertussis
      • Chlamydia pneumoniae
      • Mycoplasma pneumoniae
Attrition step persons
Patients under 6 years old with at least 1 visit during CE period 1,547,992
Had at least 1 of COVID, influenza infection event during CE period 230,219
Had COVID during CE period 171,937
Had influenza during CE period 60,624
Meets utilization inclusion criteria 154,258
Overall cohort without overlapping index infections 146,975
COVID sub-cohort 118,957
Influenza sub-cohort 32,233
Overall cohort without invalid gender and co-infections 144,838
Final COVID sub-cohort 114,414
Final Influenza sub-cohort 30,424

1.2 Table 1: Sociodemographic characteristics of study population

COVID
(N=114414)		 Influenza
(N=30424)		 Overall
(N=144838)

PI: Pacific Islander

*Low, moderate, and high utilizers correspond to the 33th, 66th, and 97.5th percentile of the number of visits in the cohort

**With a 3 year lookback period
Age categories
<6 months 18724 (16.4%) 2022 (6.6%) 20746 (14.3%)
6m-1y old 22449 (19.6%) 3343 (11.0%) 25792 (17.8%)
1-2y old 25862 (22.6%) 5874 (19.3%) 31736 (21.9%)
2-3y old 18381 (16.1%) 5779 (19.0%) 24160 (16.7%)
3-4y old 15450 (13.5%) 6320 (20.8%) 21770 (15.0%)
4-5y old 13548 (11.8%) 7086 (23.3%) 20634 (14.2%)
Gender
Female 52718 (46.1%) 14115 (46.4%) 66833 (46.1%)
Male 61696 (53.9%) 16309 (53.6%) 78005 (53.9%)
Race/ethnicity
Hispanic 25683 (22.4%) 10140 (33.3%) 35823 (24.7%)
Non-Hispanic Asian/PI 6469 (5.7%) 1196 (3.9%) 7665 (5.3%)
Non-Hispanic Black 18221 (15.9%) 6086 (20.0%) 24307 (16.8%)
Non-Hispanic Multiple 2606 (2.3%) 601 (2.0%) 3207 (2.2%)
Non-Hispanic White 46902 (41.0%) 9399 (30.9%) 56301 (38.9%)
Other/Unknown 14533 (12.7%) 3002 (9.9%) 17535 (12.1%)
Insurance class
Public 8619 (7.5%) 3641 (12.0%) 12260 (8.5%)
Private 10779 (9.4%) 2655 (8.7%) 13434 (9.3%)
Other 29686 (25.9%) 9029 (29.7%) 38715 (26.7%)
Missing 65330 (57.1%) 15099 (49.6%) 80429 (55.5%)
Prior inpatient visit frequency*
High Utilizer 1212 (1.1%) 177 (0.6%) 1389 (1.0%)
Moderate Utilizer 0 (0%) 0 (0%) 0 (0%)
Low Utilizer 17040 (14.9%) 3218 (10.6%) 20258 (14.0%)
No Visits 96162 (84.0%) 27029 (88.8%) 123191 (85.1%)
Prior outpatient visit frequency*
High Utilizer 41322 (36.1%) 8558 (28.1%) 49880 (34.4%)
Moderate Utilizer 37712 (33.0%) 10166 (33.4%) 47878 (33.1%)
Low Utilizer 22281 (19.5%) 7435 (24.4%) 29716 (20.5%)
No Visits 13099 (11.4%) 4265 (14.0%) 17364 (12.0%)
Prior ED visit frequency*
High Utilizer 1979 (1.7%) 686 (2.3%) 2665 (1.8%)
Moderate Utilizer 12116 (10.6%) 4234 (13.9%) 16350 (11.3%)
Low Utilizer 18307 (16.0%) 5458 (17.9%) 23765 (16.4%)
No Visits 82012 (71.7%) 20046 (65.9%) 102058 (70.5%)
Prior other visit frequency*
High Utilizer 35042 (30.6%) 7479 (24.6%) 42521 (29.4%)
Moderate Utilizer 28889 (25.2%) 6541 (21.5%) 35430 (24.5%)
Low Utilizer 24387 (21.3%) 5653 (18.6%) 30040 (20.7%)
No Visits 26096 (22.8%) 10751 (35.3%) 36847 (25.4%)
Test confirm diagnosis
diagnosis only 38693 (33.8%) 6953 (22.9%) 45646 (31.5%)
lab confirmed 75721 (66.2%) 4000 (13.1%) 79721 (55.0%)
lab & diagnosis 0 (0%) 19471 (64.0%) 19471 (13.4%)
Hospitalized at index visit
No 102678 (89.7%) 28068 (92.3%) 130746 (90.3%)
Yes 11736 (10.3%) 2356 (7.7%) 14092 (9.7%)
PMCA**
No 105937 (92.6%) 26620 (87.5%) 132557 (91.5%)
Yes 8477 (7.4%) 3804 (12.5%) 12281 (8.5%)
Had at least one high risk condition
Yes 54283 (47.4%) 15882 (52.2%) 70165 (48.4%)
No 60131 (52.6%) 14542 (47.8%) 74673 (51.6%)

1.3 Patient counts by sites — any respiratory outcomes

<SQL>
SELECT
  "site",
  "sub_cohort",
  "lab_confirmed_index",
  "ce_yr",
  COUNT(DISTINCT "person_id") AS "n"
FROM (
  SELECT
    "person_id",
    "sub_cohort",
    CASE WHEN ("sub_cohort" = 'Influenza' AND "lab_confirmed_index" = 'lab & diagnosis') THEN 'lab confirmed' WHEN NOT ("sub_cohort" = 'Influenza' AND "lab_confirmed_index" = 'lab & diagnosis') THEN "lab_confirmed_index" END AS "lab_confirmed_index",
    "ce_date",
    "site",
    "ce_yr"
  FROM (
    SELECT *, EXTRACT(year FROM "ce_date") AS "ce_yr"
    FROM (
      SELECT "analytic_dataset_final".*, "site"
      FROM "analytic_dataset_final"
      INNER JOIN "peds_omop"."person" AS "person"
        ON ("analytic_dataset_final"."person_id" = "person"."person_id")
    ) "q01"
  ) "q02"
) "q03"
GROUP BY "site", "sub_cohort", "lab_confirmed_index", "ce_yr"

2 Sensitivity analysis: RSV infection outcome (original aim 1)

2.1 Supplemental Table 5b: Attrition Table for b) subcohort evaluating the outcome of RSV infection

This attrition table considers the cohort entry period to be defined from March 1, 2022 to July 1, 2022. This means that the study outcome window will extend from April 1, 2022 to January 1, 2023.

Attrition based on cohort inclusion criteria. Inclusion criteria were computed according to the following rules.

  • Patients under 6 years old with at least one visit during cohort entry period (Jan 1 - July 1, 2022, may be tightened as desired)

  • Had evidence of either SARS-CoV-2 infection, Influenza, or any other respiratory infection within the cohort entry period

  • Had at least 1 visit within 18 months of index date, and at least 1 visit in the 1-6 months following the index date (follow up period)

Index sub-cohort group was selected according to the following logic:

  • Select as initial index type and date the earliest evidence of SARS-CoV-2 or Influenza or other ARI

  • If a patient’s index category is an other ARI but they have evidence of SARS-CoV-2 or Influenza within 7 days, update the index category to SARS-CoV-2/Influenza accordingly, but keep the index date the same as the preliminary ARI diagnosis

  • Exclusions:

    • No prior SARS-CoV-2 ever, via test, diagnosis, or serology positive

    • No Influenza within pre-acute or acute period (6 months before index)

    • No prior RSV (outcome) or RSV within acute period

    • No co-infection of Influenza and SARS-Cov-2 within acute period

    • For influenza index infections, no other respiratory infection positive tests within 14 days of index date. Other respsiratory infections include:

      • Adenovirus
      • Coronavirus 229E, HKU1, NL63, OC43
      • Human Metapneumovirus
      • Human Rhinovirus/Enterovirus
      • Influenza A virus A/H1, A/H3, A/H1-2009
      • Influenza B virus
      • Parainfluenza virus 1, 2, 3, 4
      • Respiratory syncytial virus
      • Bordetella parapertussis
      • Bordetella pertussis
      • Chlamydia pneumoniae
      • Mycoplasma pneumoniae
Attrition step persons
Patients under 6 years old with at least 1 visit during CE period 938,178
Had at least 1 of COVID, influenza, and/or other respiratory infection event during CE period 131,139
Had COVID during CE period 29,476
Had influenza during CE period 14,853
Had other respiratory infection during CE period 96,804
Meets utilization inclusion criteria 85,249
Overall cohort without overlapping index infections 72,379
COVID sub-cohort 18,876
Influenza sub-cohort 6,706
Other respiratory infection sub-cohort 46,784
Overall cohort without invalid gender and co-infections 72,160
Final COVID sub-cohort 18,767
Final Influenza sub-cohort 6,697
Final Respiratory sub-cohort 46,696

2.2 Supplemental Table 6: Sociodemographic characteristics of study subcohort used for RSV analyses

COVID
(N=18767)		 Influenza
(N=6697)		 Respiratory
(N=46696)		 Overall
(N=72160)

PI: Pacific Islander

*Low, moderate, and high utilizers correspond to the 33th, 66th, and 97.5th percentile of the number of visits in the cohort

**With a 3 year lookback period
Age categories
<6 months 2551 (13.6%) 288 (4.3%) 8358 (17.9%) 11197 (15.5%)
6m-1y old 3628 (19.3%) 562 (8.4%) 7891 (16.9%) 12081 (16.7%)
1-2y old 4521 (24.1%) 1234 (18.4%) 9137 (19.6%) 14892 (20.6%)
2-3y old 3127 (16.7%) 1347 (20.1%) 7576 (16.2%) 12050 (16.7%)
3-4y old 2492 (13.3%) 1573 (23.5%) 7059 (15.1%) 11124 (15.4%)
4-5y old 2448 (13.0%) 1693 (25.3%) 6675 (14.3%) 10816 (15.0%)
Gender
Female 8753 (46.6%) 3083 (46.0%) 21589 (46.2%) 33425 (46.3%)
Male 10014 (53.4%) 3614 (54.0%) 25107 (53.8%) 38735 (53.7%)
Race/ethnicity
Hispanic 3366 (17.9%) 2834 (42.3%) 11935 (25.6%) 18135 (25.1%)
Non-Hispanic Asian/PI 1595 (8.5%) 184 (2.7%) 2345 (5.0%) 4124 (5.7%)
Non-Hispanic Black 2288 (12.2%) 1201 (17.9%) 6991 (15.0%) 10480 (14.5%)
Non-Hispanic Multiple 428 (2.3%) 118 (1.8%) 1155 (2.5%) 1701 (2.4%)
Non-Hispanic White 8380 (44.7%) 1792 (26.8%) 18572 (39.8%) 28744 (39.8%)
Other/Unknown 2710 (14.4%) 568 (8.5%) 5698 (12.2%) 8976 (12.4%)
Insurance class
Public 1197 (6.4%) 995 (14.9%) 4951 (10.6%) 7143 (9.9%)
Private 2390 (12.7%) 593 (8.9%) 5458 (11.7%) 8441 (11.7%)
Other 4723 (25.2%) 1371 (20.5%) 16130 (34.5%) 22224 (30.8%)
Missing 10457 (55.7%) 3738 (55.8%) 20157 (43.2%) 34352 (47.6%)
Prior inpatient visit frequency*
High Utilizer 324 (1.7%) 52 (0.8%) 339 (0.7%) 715 (1.0%)
Low Utilizer 2645 (14.1%) 559 (8.3%) 5571 (11.9%) 8775 (12.2%)
No Visits 15798 (84.2%) 6086 (90.9%) 40786 (87.3%) 62670 (86.8%)
Prior outpatient visit frequency*
High Utilizer 8738 (46.6%) 2015 (30.1%) 13317 (28.5%) 24070 (33.4%)
Moderate Utilizer 4706 (25.1%) 1920 (28.7%) 13213 (28.3%) 19839 (27.5%)
Low Utilizer 3393 (18.1%) 1723 (25.7%) 12867 (27.6%) 17983 (24.9%)
No Visits 1930 (10.3%) 1039 (15.5%) 7299 (15.6%) 10268 (14.2%)
Prior ED visit frequency*
High Utilizer 477 (2.5%) 322 (4.8%) 370 (0.8%) 1169 (1.6%)
Moderate Utilizer 1565 (8.3%) 822 (12.3%) 2385 (5.1%) 4772 (6.6%)
Low Utilizer 2799 (14.9%) 1234 (18.4%) 6349 (13.6%) 10382 (14.4%)
No Visits 13926 (74.2%) 4319 (64.5%) 37592 (80.5%) 55837 (77.4%)
Prior other visit frequency*
High Utilizer 10953 (58.4%) 2735 (40.8%) 23298 (49.9%) 36986 (51.3%)
Low Utilizer 3920 (20.9%) 1118 (16.7%) 10105 (21.6%) 15143 (21.0%)
No Visits 3894 (20.7%) 2844 (42.5%) 13293 (28.5%) 20031 (27.8%)
Test confirm diagnosis
diagnosis only 8242 (43.9%) 1378 (20.6%) 46696 (100%) 56316 (78.0%)
lab confirmed 10525 (56.1%) 798 (11.9%) 0 (0%) 11323 (15.7%)
lab & diagnosis 0 (0%) 4521 (67.5%) 0 (0%) 4521 (6.3%)
Hospitalized for index infection
No 16972 (90.4%) 6103 (91.1%) 42634 (91.3%) 65709 (91.1%)
Yes 1795 (9.6%) 594 (8.9%) 4062 (8.7%) 6451 (8.9%)
PMCA**
No 18757 (99.9%) 6697 (100%) 46693 (100.0%) 72147 (100.0%)
Yes 10 (0.1%) 0 (0%) 3 (0.0%) 13 (0.0%)
Had at least one high risk condition
No 12770 (68.0%) 4157 (62.1%) 32719 (70.1%) 49646 (68.8%)
Yes 5997 (32.0%) 2540 (37.9%) 13977 (29.9%) 22514 (31.2%)

2.3 Patient counts by sites — RSV outcomes

<SQL>
SELECT
  "site",
  "sub_cohort",
  "lab_confirmed_index",
  "ce_yr",
  COUNT(DISTINCT "person_id") AS "n"
FROM (
  SELECT
    "person_id",
    "sub_cohort",
    CASE WHEN ("sub_cohort" = 'Influenza' AND "lab_confirmed_index" = 'lab & diagnosis') THEN 'lab confirmed' WHEN NOT ("sub_cohort" = 'Influenza' AND "lab_confirmed_index" = 'lab & diagnosis') THEN "lab_confirmed_index" END AS "lab_confirmed_index",
    "ce_date",
    "site",
    "ce_yr"
  FROM (
    SELECT *, EXTRACT(year FROM "ce_date") AS "ce_yr"
    FROM (
      SELECT "analytic_dataset_final".*, "site"
      FROM "analytic_dataset_final"
      INNER JOIN "peds_omop"."person" AS "person"
        ON ("analytic_dataset_final"."person_id" = "person"."person_id")
    ) "q01"
  ) "q02"
) "q03"
GROUP BY "site", "sub_cohort", "lab_confirmed_index", "ce_yr"

3 Figure 1: Epi curve

figure_1_epi_curve

4 Table 6: Co-infection tables

sub_cohort cohort label
COVID RSV infection within 61 to 180 days from index infection 403 (2.15 %)
COVID RSV infection within 1 to 60 days from index infection 97 (0.52 %)
COVID RSV infection on the same date as index infection 522 (2.78 %)
Influenza RSV infection within 61 to 180 days from index infection 114 (1.7 %)
Influenza RSV infection within 1 to 60 days from index infection 30 (0.45 %)
Influenza RSV infection on the same date as index infection 171 (2.55 %)

5 Figure 2: Odds ratios of unweighted, weighted, adjusted and unadjusted models

Footnote: Square and triangle shapes represent odds ratios, lines represent 95% confidence intervals. Each color represents a different model with varied time period of evaluation, weighting and adjustment. Models adjusted for age, sex, ethnicity, prior inpatient visit frequency*, prior outpatient visit frequency, prior emergency visit frequency, Hospitalization at index infection, and high risk condition.

5.1 Figure 2a RSV infection in in the 15-180 days following SARS-CoV-2 infection compared with following influenza infection

figure_2a

[1] "using LR weights"
[1] "using LR weights"
Unweighted, unadjustedUnweighted, adjustedWeighted (LR), unadjustedWeighted (LR), adjusted
(Intercept)0.02 ***0.48 *  0.03 ***0.46 ** 
[0.02, 0.02]   [0.27, 0.84]   [0.02, 0.03]   [0.26, 0.82]   
covid1.19    0.99    0.78 ** 0.78 ** 
[1.00, 1.42]   [0.82, 1.20]   [0.67, 0.91]   [0.67, 0.91]   
age_group1-2y old       0.41 ***       0.35 ***
       [0.32, 0.53]          [0.28, 0.45]   
age_group2-3y old       0.30 ***       0.25 ***
       [0.23, 0.40]          [0.19, 0.33]   
age_group3-4y old       0.21 ***       0.18 ***
       [0.15, 0.29]          [0.13, 0.25]   
age_group4-5y old       0.10 ***       0.09 ***
       [0.06, 0.15]          [0.06, 0.13]   
age_group6m-1y old       0.60 ***       0.64 ***
       [0.46, 0.77]          [0.51, 0.81]   
race_eth_catNH_Asian/PI       1.04           0.99    
       [0.71, 1.52]          [0.69, 1.42]   
race_eth_catNH_Black/AA       1.06           1.26 *  
       [0.84, 1.35]          [1.01, 1.58]   
race_eth_catNH_Multiple       1.00           0.72    
       [0.60, 1.65]          [0.42, 1.24]   
race_eth_catNH_White       0.90           0.91    
       [0.72, 1.11]          [0.75, 1.12]   
race_eth_catOther/Unknown       0.62 *         0.55 ** 
       [0.43, 0.90]          [0.38, 0.79]   
sex_catMale       0.94           1.09    
       [0.80, 1.11]          [0.93, 1.27]   
hospitalized_at_indexNot hospitalized       0.25 ***       0.23 ***
       [0.21, 0.30]          [0.19, 0.28]   
util_inpatientlow_utilizer       0.71           0.92    
       [0.45, 1.11]          [0.57, 1.50]   
util_inpatientno_visits       0.72           0.91    
       [0.46, 1.11]          [0.56, 1.47]   
util_outpatientlow_utilizer       1.03           0.98    
       [0.80, 1.31]          [0.77, 1.24]   
util_outpatientmoderate_utilizer       0.84           0.78 *  
       [0.66, 1.05]          [0.62, 0.97]   
util_outpatientno_visits       1.20           1.18    
       [0.91, 1.57]          [0.92, 1.52]   
util_edlow_utilizer       0.72 *         0.71 *  
       [0.51, 1.00]          [0.52, 0.98]   
util_edmoderate_utilizer       0.67 *         0.65 *  
       [0.47, 0.94]          [0.47, 0.91]   
util_edno_visits       0.46 ***       0.49 ***
       [0.33, 0.63]          [0.36, 0.66]   
util_otherlow_utilizer       0.80           0.78 *  
       [0.63, 1.01]          [0.62, 0.98]   
util_otherno_visits       0.88           0.92    
       [0.71, 1.09]          [0.75, 1.12]   
highrisk_flagYes       1.46 ***       1.35 ***
       [1.22, 1.75]          [1.14, 1.61]   
N28674       28674       28674       28674       
AIC5988.59    5465.46                  
BIC6005.12    5672.05                  
Pseudo R20.00    0.10    0.00    0.10    
*** p < 0.001; ** p < 0.01; * p < 0.05.

5.2 Figure 2b any respiratory infection in the 30 to 180 days following SARS-CoV-2 infection compared with following influenza infection

figure_2a

Unweighted, unadjustedUnweighted, adjustedWeighted (LR), unadjustedWeighted (LR), adjusted
(Intercept)0.70 ***1.34 ***0.76 ***1.45 ***
[0.68, 0.73]   [1.16, 1.55]   [0.74, 0.78]   [1.26, 1.67]   
covid0.69 ***0.69 ***0.63 ***0.64 ***
[0.66, 0.71]   [0.67, 0.72]   [0.61, 0.65]   [0.62, 0.67]   
age_group1-2y old       0.67 ***       0.64 ***
       [0.64, 0.70]          [0.61, 0.67]   
age_group2-3y old       0.64 ***       0.62 ***
       [0.62, 0.67]          [0.59, 0.65]   
age_group3-4y old       0.64 ***       0.60 ***
       [0.61, 0.67]          [0.58, 0.63]   
age_group4-5y old       0.58 ***       0.55 ***
       [0.55, 0.60]          [0.53, 0.58]   
age_group6m-1y old       0.80 ***       0.77 ***
       [0.76, 0.83]          [0.74, 0.81]   
race_eth_catNH_Asian/PI       0.78 ***       0.78 ***
       [0.73, 0.82]          [0.74, 0.83]   
race_eth_catNH_Black/AA       0.71 ***       0.71 ***
       [0.68, 0.74]          [0.68, 0.73]   
race_eth_catNH_Multiple       0.77 ***       0.81 ***
       [0.71, 0.84]          [0.75, 0.87]   
race_eth_catNH_White       0.89 ***       0.89 ***
       [0.86, 0.91]          [0.87, 0.92]   
race_eth_catOther/Unknown       0.70 ***       0.72 ***
       [0.67, 0.73]          [0.69, 0.76]   
sex_catMale       1.02           1.01    
       [0.99, 1.04]          [0.99, 1.04]   
hospitalized_at_indexYes       1.40 ***       1.39 ***
       [1.34, 1.45]          [1.34, 1.45]   
util_inpatientlow_utilizer       1.22 **        1.18 ** 
       [1.08, 1.38]          [1.04, 1.33]   
util_inpatientno_visits       1.36 ***       1.34 ***
       [1.21, 1.53]          [1.19, 1.50]   
util_outpatientlow_utilizer       0.68 ***       0.67 ***
       [0.65, 0.70]          [0.64, 0.69]   
util_outpatientmoderate_utilizer       0.75 ***       0.74 ***
       [0.73, 0.77]          [0.72, 0.76]   
util_outpatientno_visits       0.68 ***       0.66 ***
       [0.65, 0.70]          [0.63, 0.69]   
util_edlow_utilizer       0.62 ***       0.64 ***
       [0.57, 0.67]          [0.59, 0.69]   
util_edmoderate_utilizer       0.71 ***       0.74 ***
       [0.66, 0.77]          [0.68, 0.80]   
util_edno_visits       0.49 ***       0.51 ***
       [0.45, 0.53]          [0.47, 0.55]   
util_otherlow_utilizer       1.02           1.04 *  
       [0.99, 1.06]          [1.00, 1.08]   
util_othermoderate_utilizer       0.92 ***       0.93 ***
       [0.89, 0.95]          [0.90, 0.96]   
util_otherno_visits       1.38 ***       1.37 ***
       [1.33, 1.42]          [1.32, 1.42]   
highrisk_flagYes       1.71 ***       1.75 ***
       [1.66, 1.75]          [1.71, 1.79]   
N133086       133086       133086       133086       
AIC169357.46    163155.81                  
BIC169377.06    163410.58                  
Pseudo R20.00    0.07    0.00    0.07    
*** p < 0.001; ** p < 0.01; * p < 0.05.

5.3 Figure 2c any infection in the 30 to 180 days following SARS-CoV-2 infection compared with following influenza infection

figure_2a

[1] "using LR weights"
[1] "using LR weights"
Unweighted, unadjustedUnweighted, adjustedWeighted (LR), unadjustedWeighted (LR), adjusted
(Intercept)0.84 ***2.23 ***0.90 ***3.36 ***
[0.81, 0.87]   [1.93, 2.58]   [0.88, 0.91]   [2.88, 3.93]   
covid0.77 ***0.78 ***0.71 ***0.72 ***
[0.74, 0.80]   [0.75, 0.81]   [0.70, 0.73]   [0.71, 0.74]   
age_group1-2y old       0.70 ***       0.63 ***
       [0.67, 0.73]          [0.60, 0.65]   
age_group2-3y old       0.65 ***       0.62 ***
       [0.62, 0.68]          [0.59, 0.64]   
age_group3-4y old       0.62 ***       0.54 ***
       [0.59, 0.65]          [0.52, 0.57]   
age_group4-5y old       0.57 ***       0.51 ***
       [0.55, 0.60]          [0.49, 0.54]   
age_group6m-1y old       0.85 ***       0.83 ***
       [0.81, 0.88]          [0.79, 0.86]   
race_eth_catNH_Asian/PI       0.76 ***       0.74 ***
       [0.72, 0.81]          [0.70, 0.78]   
race_eth_catNH_Black/AA       0.70 ***       0.72 ***
       [0.67, 0.72]          [0.69, 0.74]   
race_eth_catNH_Multiple       0.77 ***       0.82 ***
       [0.71, 0.83]          [0.76, 0.88]   
race_eth_catNH_White       0.80 ***       0.81 ***
       [0.77, 0.82]          [0.79, 0.83]   
race_eth_catOther/Unknown       0.67 ***       0.73 ***
       [0.64, 0.70]          [0.70, 0.76]   
sex_catMale       0.98           0.97 ** 
       [0.96, 1.00]          [0.95, 0.99]   
hospitalized_at_indexYes       1.39 ***       1.39 ***
       [1.34, 1.45]          [1.33, 1.44]   
util_inpatientlow_utilizer       1.03           0.77 ***
       [0.91, 1.16]          [0.67, 0.88]   
util_inpatientno_visits       1.12           0.85 *  
       [1.00, 1.26]          [0.75, 0.98]   
util_outpatientlow_utilizer       0.67 ***       0.63 ***
       [0.65, 0.70]          [0.61, 0.66]   
util_outpatientmoderate_utilizer       0.76 ***       0.71 ***
       [0.74, 0.78]          [0.69, 0.73]   
util_outpatientno_visits       0.71 ***       0.64 ***
       [0.68, 0.74]          [0.61, 0.66]   
util_edlow_utilizer       0.59 ***       0.60 ***
       [0.55, 0.64]          [0.56, 0.65]   
util_edmoderate_utilizer       0.70 ***       0.70 ***
       [0.65, 0.76]          [0.65, 0.75]   
util_edno_visits       0.44 ***       0.47 ***
       [0.41, 0.48]          [0.44, 0.51]   
util_otherlow_utilizer       1.00           1.07 ***
       [0.96, 1.03]          [1.03, 1.11]   
util_othermoderate_utilizer       0.90 ***       0.92 ***
       [0.87, 0.93]          [0.89, 0.95]   
util_otherno_visits       1.31 ***       1.38 ***
       [1.26, 1.35]          [1.33, 1.43]   
highrisk_flagYes       1.74 ***       1.61 ***
       [1.69, 1.78]          [1.57, 1.65]   
N133183       133183       133183       133183       
AIC178935.57    171371.45                  
BIC178955.17    171626.24                  
Pseudo R20.00    0.08    0.00    0.08    
*** p < 0.001; ** p < 0.01; * p < 0.05.

6 Figure S3: Results of IPTW illustrating the balance achieved when using propensity score weighting to reduce confounding of covariates with the exposure (SARS-Cov-2 infection compared to influenza

  • Footnote: The propensity weighting accounts for age, sex, ethnicity, time of index infection and high risk conditions.

6.1 Figure S3_a: RSV outcome

figure_s3a

6.2 Figure S3_b: Respiratory infection outcome

figure_s3b

6.3 Figure S3_c: Any infection outcome

figure_s3c